Purpose: The purpose of this paper is to determine the safety and effectiveness of gadolinum contrast in patients with allergy iodinated contrast. Methods: A retrospective review of all patients with biliary tract disease that required a therapeutic endoscopy retrograde admitted to Hospital Universitario Mayor - Universidad del Rosario between January 1, 2000, and December 31, 2009, was conducted. Clinical data were collected as well as the contrast media that were used in therapeutic ERCP. Results: During the 10 years of analysis were performed 3578 ERCP. Four required gadolinum contrast due to previous allergy to iodinated contrast. These four patients had previous severe anaphylactic reaction to iodinated contrast media that required reanimation maneuvers in an intensive care unit. ERCP was necessary in a cholangiocarcinoma case, two with choledocolitiasis and one with biliary fistula after laparoscopic cholecystectomy. Gadolinum was injected in the common bile duct. Thanks to the images obtained, we could resolve the problem. We did not observe any adverse effect of Gadolinum, even the amilasemia remained normal after the ERCP. Conclusion: Our results indicated that in patients with previous allergy to iodinated contrast we may use Gadolinum contrast. These findings support that in patients with iodinated contrast allergy on the base of our experiences, we recommend the Gadolinium as an alternative contrast media in therapeutic ERCP.Figure